Acute massive hepatic necrosis with fatal liver failure

1971 ◽  
Vol 16 (9) ◽  
pp. 803-808 ◽  
Author(s):  
Charles M. Caravati ◽  
Timothy H. Hooker
Keyword(s):  
Liver Failure ◽  
Hepatic Necrosis ◽  
Fatal Liver ◽  
Massive Hepatic Necrosis ◽  
Fatal Liver Failure

Fatal Liver Failure in a Patient on Acetaminophen Treated with Sunitinib Malate and Levothyroxine

2009 ◽  
Vol 43 (4) ◽  
pp. 761-766 ◽  
Author(s):  
Amy M Weise ◽  
Chin Y Liu ◽  
Anthony F Shields
Keyword(s):  
Liver Failure ◽  
Assessment Method ◽  
Hepatic Necrosis ◽  
Potential Interaction ◽  
Neoplastic Disease ◽  
Sunitinib Malate ◽  
Sunitinib Treatment ◽  
Case Summary ◽  
Disease Stabilization ◽  
Fatal Liver Failure

Objective: To report the occurrence of fatal acute liver failure following addition of levothyroxine to a regimen of sunitinib and acetaminophen. Case Summary: A 57-year-old woman who started sunitinib treatment for relapsed metastatic gastrointestinal stromal tumor after imatinib failure had disease stabilization and normal livar function through 8 cycles of sunitinib 50 mg/day for 4 weeks, followed by 2 weeks off treatment. Her continuing medications included acetaminophen approximately 4.5 g/wk, as well as standard medications for asthma. In cycle 8, she received oral levothyroxine 50–150 pg/day for approximately 30 days to control hypothyroidism before beginning cycle 9 of sunitinib. On day 4 of cycle 9, she was hospitalized with progressively rising circulating liver enzyme levels. She died 4 days postadmission despite discontinuation of sunitinib and initiation of Intensive supportive treatment. At autopsy, her liver showed severe centrliobular necrosis with moderate-to-severe steatosis and minimal parenchymal invasion by the neoplasm. Viral stains were negative. Discussion: Hepatic failure has been reported rarely in patients receiving sunitinib. Autopsy results excluded neoplastic disease progression and viral infection in the etiology of the event, and the patient may have died of the combined interaction of sunitinib, acetaminophen, and levothyroxine. Although sunitinib was not more than a possible hepatotoxin (Roussel Uclaf Causality Assessment Method) and may even have been hepatoprotective over a 48-week period against chronic intake of acetaminophen (probable hepatotoxin) by producing regional hypothyroidism within the liver, it is hypothesized that correction of the putative hepatic hypothyroidism with oral levothyroxine (possible hepatotoxin) and reinitiation of sunitinib treatment may have triggered hepatic necrosis. Conclusions: Acetaminophen should be used with particular caution in patients receiving sunitinib. In sunitinib-treated patients who also require levothyroxine therapy, increased caution in restarting subsequent sunitinib treatment and discontinuation of acetaminophen, if possible, is advisable. Further evaluation of this potential interaction is warranted.

Acute Fulminant Hepatic Failure in a Woman Treated With Phenytoin and Trimethoprim-Sulfamethoxazole

2000 ◽  
Vol 124 (12) ◽  
pp. 1800-1803 ◽  
Author(s):  
Marius J-M. Ilario ◽  
Jose E. Ruiz ◽  
Constantine A. Axiotis
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Acute Hepatic Failure ◽  
Hepatic Necrosis ◽  
Rare Occurrence ◽  
Autopsy Findings ◽  
Massive Hepatic Necrosis

Abstract Massive hepatic necrosis following exposure to phenytoin and trimethoprim-sulfamethoxazole is a rare occurrence and to the best of our knowledge has not been reported previously. Acute hepatic failure following administration of trimethoprim-sulfamethoxazole has rarely been seen, and only 4 cases have been well documented pathologically. We report a case of acute liver failure in a 60-year-old woman following ingestion of phenytoin and trimethoprim-sulfamethoxazole concomitantly over a 9-day period. Autopsy findings revealed acute fulminant hepatic failure. This case demonstrates the effects of chemical-chemical interactions in the potentiation of hepatotoxicity of single agents and specifically illustrates the need for discontinuing trimethoprim-sulfamethoxazole in the presence of early liver injury.

scholarly journals Non-Fatal and Fatal Liver Failure Associated with Valproic Acid

2012 ◽  
Vol 46 (02) ◽  
pp. 63-68 ◽  
Author(s):  
M. Schmid ◽  
R. Freudenmann ◽  
F. Keller ◽  
B. Connemann ◽  
C. Hiemke ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Liver Failure ◽  
Fatal Liver ◽  
Fatal Liver Failure

scholarly journals Fatal liver failure after the administration of raltitrexed for cancer chemotherapy

Cancer ◽  
2000 ◽  
Vol 89 (4) ◽  
pp. 890-892 ◽  
Author(s):  
Markus Raderer ◽  
Wolfgang Fiebiger ◽  
Friedrich Wrba ◽  
Werner Scheithauer
Keyword(s):  
Liver Failure ◽  
Cancer Chemotherapy ◽  
Fatal Liver ◽  
Fatal Liver Failure

Fatal liver failure in haemophiliacs with HIV‐induced immunodeficiency: observation of six patients

Haemophilia ◽  
1999 ◽  
Vol 5 (2) ◽  
pp. 109-114
Author(s):  
H. TOYODA ◽  
Y. FUKUDA ◽  
I. NAKANO ◽  
Y. KATANO ◽  
J. TAKAMATSU ◽  
...  
Keyword(s):  
Liver Failure ◽  
Fatal Liver ◽  
Fatal Liver Failure

Fatal Liver Failure in an Adult Patient with Acute Lymphoblastic Leukemia following Treatment with L-Asparaginase

Digestion ◽  
2006 ◽  
Vol 74 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Michael Bodmer ◽  
Michael Sulz ◽  
Sylvia Stadlmann ◽  
Armin Droll ◽  
Luigi Terracciano ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Liver Failure ◽  
Adult Patient ◽  
Lymphoblastic Leukemia ◽  
Fatal Liver ◽  
Fatal Liver Failure
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